Play Podcast Download Podcast

Transcription:

Prakash Chandran (Host): Did you know that there are steps you can take to reduce the risk of getting cancer? While risk factors such as family history and aging can’t be controlled; there are certainly lifestyle changes that you can make to lower your risk of contracting disease. I’m Prakash Chandran and in this episode of Ridgecrest Regional Hospital Podcast, we will talk about prevention measures to reduce the risk of getting cancer. Here with us to discuss is Dr. Everard Hughes, a medical oncologist and hematologist at Ridgecrest. Pleasure to have you here Dr. Hughes. So, let’s get started with a basic question. In medicine today, what is understood about why we get cancer?

Everard Hughes, MD (Guest): Thanks for having me on the program. Well, it’s all about molecular and protein interactions. Our bodies are a collection of proteins that have functions. These proteins are designed and produced by our genetic code. If the gene instructions are damaged, then the function of the proteins are altered or in a worse case scenario; the function of the protein is completely lost. If the genetic code for cell growth or cell division is damaged; this damage causes uncontrolled cell division or cancer. What can damage our genetic code? Radiation, environmental chemicals, tobacco, and viruses.

Host: So, you are already kind of getting into some of the things I wanted to ask about. You said radiation, tobacco, chemicals, things of that nature. I’m assuming that we as humans, get exposed to a lot of that stuff by lifestyle choices that we make day to day. Isn’t that true?

Dr. Hughes: That’s correct. That’s correct.

Host: So, let’s talk about maybe the first and foremost thing that’s on most people’s minds which is diet. What can we be eating or what should we stay away from in order to prevent our risk of getting cancer?

Dr. Hughes: Okay, so it is not so important to avoid certain foods; it is important to recognize that the way food is prepared or processed, may influence our ability to avoid cancer. Frequent consumption of meats cook at high temperatures such as by barbecuing or frying causes the production of what we call polycyclic aromatic hydrocarbon molecules which are shown to be associated with an increased risk of colon and rectal cancer, pancreatic and prostate cancer. These molecules structurally look like our DNA and accordingly, may interact with our genetic code. We must be aware that certain processed foods contain preservatives and we should be looking at the labels to realize that and these preservatives such as sodium nitrate and sodium nitrite which have been classified by the International Agency for the Research of Cancer as probably cancer causing chemicals.

Now I know the question also involved exercise. So, as far as exercise goes; cancer specialists know that there is an association between obesity and the risk of developing breast cancer, pancreatic cancer, uterine cancer, kidney cancer, rectal and colon cancer. Physical activity of at least three hours per week, strenuous activity; seems to provide a reduction in the risk for developing these cancers.

Host: One of the questions that I was going to ask you about is it really seems like whenever there is a case of cancer or a loved one that I know has cancer; it is always specific to one body part or organ. But what I’m hearing you say is that being mindful of the way your food is processed and living a healthy lifestyle can actually prevent all types of cancer. Would you say that that is true?

Dr. Hughes: Except for those that are caused by genetic inheritance, yes that is correct. But I think that some individuals will just have that predisposition based on just inheriting certain genes that they all have to be aware of what those genetic changes are. But there are things that we can do about our environment and our diet to help prevent cancer.

Host: So, I want to backtrack a little bit and talk about the way that food is prepared. You mentioned that consuming meat that is cooked at a very high temperature can potentially produce those cancer causing chemicals that we should stay away from. Is there any other best practices that we should follow when consuming food?

Dr. Hughes: I think that’s the main association, the preservatives and the way we are preparing our foods. And this is a – this is a society that likes fast foods, so we really have to watch out about that.

Host: Absolutely. I feel like I’m guilty of that from time to time. So, less of that is more certainly. In doing research for this, I came across the term free radicals. So, I would love for you to talk a little bit about how free radicals can lead to cancer and how might antioxidants help combat them?

Dr. Hughes: Okay. A free radical is a molecule that has gained or lost an electron. If we think back to our chemistry; that vision may come up that there’s a loss of electron. But free radicals inevitably can interact with cellular molecules and result in disruption of cellular processes, especially that we are concerned about is interference with regulation of cell growth. So, high concentrations of these potentially damaging molecules can accumulate in the body and it’s due to tobacco or certain metals such as iron, copper, chromium, cobalt, arsenic, or by alcoholic beverages. In my opinion, the two most damaging commercial products in our environment that we can regularly do something about are alcohol and tobacco. There are studies that confirm that ethanol consumption is associated with the development of oral cancer, liver cancer, esophageal cancer, breast and colon cancer.

Should we be adding antioxidants to our diet? Antioxidants are molecules that neutralize free radicals by cancelling out that electronic charge. Examples of dietary antioxidants include beta carotene found in carrots, lycopene found in tomatoes, vitamin A, vitamin C and vitamin E. However, as of 2018, there are nine randomized control trials studying whether dietary antioxidant supplements have any effect on cancer prevention. These trials have shown no benefit to adding antioxidants to our diet. In fact, several of the trials – in several of the trials, there were increased incidence of certain cancers, a paradoxical effect there. So, the conclusion is antioxidants do not help prevent cancer. So, I hope that answers the question about free radicals.

Host: Absolutely. It’s just so surprising for me to hear that because we have heard for so long and we continue to hear the importance of consuming antioxidants in the things that we eat and it’s just crazy that that study basically disproved it and it’s pretty recent, right, it was just last year.

Dr. Hughes: Right, exactly.

Host: So, let’s talk about vitamins or dietary supplements. Are there any sort of – or is there anything that we should be taking to help combat some of this? you mentioned I know antioxidants don’t work, but what about vitamins?

Dr. Hughes: Okay, again, as of 2019, and this may change in the future obviously, there are no vitamins or supplements known to prevent the development of cancer. There are some vaccinations that we should be aware of such as for both males and females ages 11-26, should receive vaccination against the human papilloma virus. It is also known as HPV. HPV is linked to six types of cancer, so vaccination helps prevent these oral and genital diseases as well as oral and genital cancers in both males and females caused by this virus. Also, hepatitis B vaccination prevents liver cancer. Of course, the caveat there is that most cancers are not caused by viruses. So, we are back to square one with the environmental factors that we have to be aware of.

Host: Right, wow this is so eye opening and I know it will be for our audience as well. So, I think if I can just recap what I’ve heard, the things that you can do is in terms of your diet watch how your food is processed. Watch if there is any preservatives in the food specifically sodium nitrate and sodium nitrite. And then of course, exercise is very important. Stay active and do that regularly. One more thing that I wanted to ask about is sun exposure. We always hear about getting exposed to too much sun, you can get skin cancer from that. Can you talk a little bit about that?

Dr. Hughes: Oh sure. Sun exposure is always a risk. There are over one million – I was surprised at this too, one million new cases of skin cancer every year in the United States. So, how much sun exposure is safe? I don’t know that we know that answer. The risk for skin cancer follows skin pigmentation, hair and eye color and what continent you actually live in. So, if anybody wants to do further study on this, a summary of this risk can be found by searching for the Fitzpatrick Scale and UV risk. So, that’s “Fitzpatrick Scale and ultraviolet risk” and it will give you some idea of whether a particular person is at risk for skin cancer.

Host: That’s a really helpful resource. I have to ask, because I know some people are going to be thinking this in their mind, the people that do like to drink; let’s say even if it’s just a glass of wine a night or they like to smoke when they go out; can you talk to us a little bit about the acceptable levels of that type of consumption or is it a pretty much a zero tolerance when it comes to protecting yourself?

Dr. Hughes: I think any percentage over the percentages found in wine is not a good idea. And that’s any amount. That’s kind of a blanket statement I know, but what people usually do is they combine tobacco with the alcohol and that’s two risk factors together. So, as an oncologist, I’m going to say well, nothing over the percentage of alcohol found in wine.

Host: Okay. Okay folks, so I think we all have our answer. If we want to live a happy and healthy life; it’s diet, it’s exercise; it’s avoiding those levels of alcohol and certainly tobacco. And you know Dr. Hughes, this has been vastly eye opening for me especially with the antioxidants and we really appreciate your insights into these cancer prevention measures. Is there anything else you want to share with the audience?

Dr. Hughes: I think that covers most of the things. I appreciate your having me on.

Host: Of course. And for more information please visit www.rrh.org. My guest today has been Dr. Everard Hughes And he is the oncologist based at Ridgecrest Regional Hospital's Cancer Center, in affiliation with the UC Davis Health Cancer Care Network. I’m Prakash Chandran. Thanks so much for listening.